FAQ - Group Dental Insurance
What You Need To Know About Group Dental Insurance in Madison, WI
What is the criteria for selecting dentists to participate in your group dental insurance program?
Our group dental insurance plans offer coverage for a wide range of quality dentists who are credited and certified by the American Dental Association (ADA) and the Commission on Dental Accreditation (CODA). Your employees are sure to find a highly qualified dentist that is convenient for their needs and location.
Are there benefits for employees who require special care?
Yes. Our group insurance plans are flexible and affordable, covering a wide range of dental services and needs. Your employees will be able to choose their level of coverage. From basic services and preventative care to restorative and other dental care services, Momentum has an insurance plan that will be right for all of your employees.
What is the difference between Employer and Employee sponsored?
Employee sponsored offers a discounted rate for employees to pay for dental insurance themselves and Employer Sponsored is when an employer offers all or most of the dental coverage.
Will my employees be able to keep their current dentist?
If their current provider is a part of our network of premier dentists, they will not have to change their current dental care provider. If their current dentist is not part of our network, they will be able to choose another provider meeting their needs from our network. Our network includes a significant number of dentists across Wisconsin. To see which dentists are covered in your area, please see our Wisconsin dental care provider network.
Do the insurance plans cover routine dental procedures such as crowns and root canals?
Yes. All of our plans are customizable to treat any number of dental procedures.
Are dependents of the employee covered under the group dental insurance plans?
Yes. Spouses and children (up to the age of 26) are covered by our flexible, customizable insurance plans.
What limitations does the plan place on pre-existing conditions? (E.g. missing teeth)
Momentum insurance plans exclude the following:
- Services or prosthetics started before the date of coverage eligibility.
- Dental procedures treating injuries or diseases caused by or related to riots or any other form of civil disobedience.
- Dental procedures treating injuries sustained during a criminal act.
- Dental procedures treating deliberate self-inflicted injuries.
- Orthodontic services, including replacement and repair of orthodontic appliances.
To see all situations where Momentum does not provide coverage, visit the Exclusions page.
Is there coverage when a patient must see a non-contracted dentist after hours or while traveling?
Yes, but only in the case of emergency treatment.
Does the plan cover emergency treatment?
Yes. Emergency treatment is covered both inside and outside of the Momentum Service Area, except for treatment needed to address injuries or disease resulting from civil disobedience or criminal activity.
What amount of the premium paid by employers or beneficiaries goes to actual treatment?
The premium paid by the employer and the percentage of it going to treatment vary by plan. Call Momentum’s experts today to learn the specifics of your unique group dental insurance plan.
May I choose a dentist outside the network?
Yes, you are always free to choose the dentist of your choice. However, your out-of-pocket costs may be higher. Your dentist has not agreed to accept negotiated fees, so you may be responsible for a difference in cost between the dentist's fee and your plan's benefit payment.
Can my dentist apply for participation in the network?
Yes, you can ask your dentist to apply to the network. Due to contractual requirements, your insurance company is prevented from soliciting providers.
How can I see if my provider is in network?
Check to see if your provider is in network using our handy Provider Search Tool.
What is an Explanation of Benefits (EOB)?
After a dentist visit, you will recieve a document in the mail that lists the services, procedures and tests you recieved during your treatment, most likely with the cost listed in dollars. This is not a bill, but rather a breakdown of the services you received and their total costs. The statement will show what portion of these services was covered by your insurance. Although EOBs may vary between companies and types of insurance, it should include the dentist's fees, the portion your insurance paid and the amount you may owe, (such as deductible, coinsurance, or non-covered services.) It should also include an update of how much of your annual maximum has been used and the amount you have paid toward your deductible.
Can I contact someone for help?
Momentum Insurance customer service is available at 608-729-6500, or toll free at 1-866-421-6649, or you can email us at firstname.lastname@example.org
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